NON-TUBERCULOUS PULMONARY CAVITARY LESION FOUND INCIDENTALLY IN PATIENT PRESENTING WITH SYNCOPE

We present a 16-year-old girl with a history of well-controlled psoriasis, on immunosuppression, who sought evaluation in the emergency department for 4 months of fever, cough and unintentional weight loss. The patient had seen multiple providers who had diagnosed her with community-acquired pneumonia, but she was unimproved after oral antibiotic therapy. On presentation, she was noted to be febrile, tachycardic and chronically ill-appearing. Her chest X-ray showed diffuse opacities and a right upper lobe cavitary lesion concerning for tuberculosis. A subsequent chest CT revealed miliary pulmonary nodules in addition to the cavitary lesion. The patient underwent subsequent brain MRI, which revealed multifocal ring-enhancing nodules consistent with parenchymal involvement. The patient was diagnosed with miliary tuberculosis and improved on quadruple therapy. Though rates of tuberculosis are increasing, rates remain low in children, though special consideration should be given to children who are immunosuppressed.

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Pulmonary Embolism and Giant Cavitary Lesion Developing After COVID-19 Pneumonia

HCA Healthcare Journal of Medicine ◽

10.36518/2689-0216.1109 ◽

2020 ◽

Vol 1 (0) ◽

Author(s):

Ahmet Vural ◽

Ahmet Nedim Kahraman

Keyword(s):

Pulmonary Embolism ◽

Cavitary Lesion

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Proven pulmonary aspergillosis in a COVID-19 patient: A case report

Current Medical Mycology ◽

10.18502/cmm.7.2.7031 ◽

2021 ◽

Author(s):

Sadegh Khodavaisy ◽

Nasim Khajavirad ◽

Seyed Jamal Hashemi ◽

Alireza Izadi ◽

Seyed Ali Dehghan Manshadi ◽

...

Keyword(s):

Case Report ◽

Fungal Infections ◽

Left Lung ◽

Aspergillus Species ◽

Pulmonary Aspergillosis ◽

Biopsy Material ◽

Cavitary Lesion ◽

Healthcare Settings ◽

Increased Risk ◽

History Of

Background and Purpose: Coronavirus disease 2019 (COVID-19) has become a significant clinical challenge in healthcare settings all over the world. Critically ill COVID-19 patients with acute respiratory distress syndrome may be at increased risk of co-infection with pulmonary aspergillosis. This study aimed to describe a clinical case of proven pulmonary aspergillosis caused by Aspergillus tubingensis in a 59-year-old man with a history of hospitalization due to COVID-19 infection. Case report: The Covid-19 infection was confirmed by positive nasopharyngeal polymerase chain reaction. He had a cavitary lesion measured 20 mm in diameter with intracavitary soft tissue density in the left lung in the first chest computerized tomography scan. After 25 days, he showed two cavitary lesions in both lungs which raised suspicion of fungal infection; hence, the patient underwent a trans-thoracic biopsy of the cavitary lesion. The direct examination and culture of the biopsy material revealed Aspergillus species. To confirm the Aspergillus species identification, the beta-tubulin region was sequenced. The patient was treated with oral voriconazole. Conclusion: This report underlined the importance of early diagnosis and management of invasive fungal infections in severe COVID-19 patients

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DIAMETER, THICKNESS AND DISCORDANCE DEGREE OF SOLITARY PULMONARY CAVITARY LESION TO DIFFERENTIATE BENIGN FROM MALIGNANT LESIONS, A MUTLISLICE CT STUDY.

Basrah Journal of Surgery ◽

10.33762/bsurg.2018.160103 ◽

2018 ◽

Vol 24 (1) ◽

pp. 9-14

Author(s):

Ammar Mosa Jawad A ◽

Mohammed Abd kadhim A ◽

Husham Jubran Mousa A

Keyword(s):

Cavitary Lesion ◽

Malignant Lesions

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Risk Factors and Epidemiology of Coccidioidomycosis Demonstrated by a Case of Spontaneous Pulmonary Rupture of Cavitary Coccidioidomycosis

Case Reports in Infectious Diseases ◽

10.1155/2016/8165414 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Amy A. Yau

Keyword(s):

Surgical Repair ◽

Oral Surgery ◽

Community Acquired Pneumonia ◽

Spontaneous Resolution ◽

Construction Work ◽

Air Leak ◽

Chest Computed Tomography ◽

Cavitary Lesion ◽

Hispanic Male ◽

Persistent Air Leak

A 31-year-old Hispanic male with no medical history was admitted for fevers, pleurisy, and cough after recent oral surgery and completing demolition and construction work in Juarez, Mexico. Imaging showed a 4.4 cm cavitary lesion and bilateral tree-in-bud opacities. Initial suspicion of bacterial infection confirmed with clinical improvement on culture specific antibiotics, but after discharge he returned with progression of symptoms and new dyspnea. Radiograph showed a pyopneumothorax. Chest computed tomography after thoracostomy showed worsening infiltrates and another cavitary lesion. Symptoms persisted despite addition of broad spectrum antibiotics. Surgical repair for persistent air leak was required. Weeks after discharge, cultures and serologies returned positive forCoccidioidomycosis immitis.Coccidioidesspecies cause up to 30% of community-acquired pneumonia and incidental cavitary lesions in endemic regions. Symptoms are nonspecific yet usually involve fatigue, cough, and pleurisy. Most hosts have spontaneous resolution; however, certain demographics such as Hispanics and diabetics, later diagnosed in our patient, have higher morbidity. As seen with our patient, cavitary rupture and bronchopleural fistulas are rare occurring in 2.6% of cavitary lesions. High suspicion based on symptoms and host demographics is important to assist in early diagnosis and treatment to avoid and treat this common pathogen’s presentations.

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